《中国康复理论与实践》

《中国康复理论与实践》 ›› 2024, Vol. 30 ›› Issue (8): 979-992.doi: 10.3969/j.issn.1006-9771.2024.08.014

• 应用研究 • 上一篇    

成年卒中后非流畅性失语症患者言语韵律功能特征

王哲1,2, 万勤1,2(), 黄昭鸣1,2, 王勇丽1,2, 钱红3   

  1. 1.华东师范大学教育学部康复科学系，上海市 200062
    2.华东师范大学中国言语听觉康复科学与ICF应用研究院，上海市 200062
    3.上海市第五康复医院康复医学科，上海市 201600
  • 收稿日期:2024-06-17 出版日期:2024-08-25 发布日期:2024-09-11
  • 通讯作者: 万勤(1982-)，女，博士，副教授，主要研究方向：言语语言康复。E-mail： qwan@spe.ecnu.edu.cn
  • 作者简介:王哲(1999-)，女，汉族，上海市人，硕士，治疗师，主要研究方向：成人言语障碍的评估及矫治。
  • 基金资助:
    国家社会科学基金项目(20AZD125)

Characteristics of speech prosody function in adults with non-fluent aphasia after stroke

WANG Zhe1,2, WAN Qin1,2(), HUANG Zhaoming1,2, WANG Yongli1,2, QIAN Hong3   

  1. 1. Department of Rehabilitation Science, Faculty of Education, East China Normal University, Shanghai 200062, China
    2. Institute of Chinese Speech and Hearing Rehabilitation Science and ICF Application, East China Normal University, Shanghai 200062, China
    3. Department of Rehabilitation Medicine, Shanghai Fifth Rehabilitation Hospital, Shanghai 201600, China
  • Received:2024-06-17 Published:2024-08-25 Online:2024-09-11
  • Supported by:
    National Social Science Foundation (Key)(20AZD125)

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摘要：

目的 探讨非流畅性失语症患者言语韵律组块、情感、焦点、交互韵律功能的特征。

方法 2023年12月至2024年3月，于上海市第五康复医院招募卒中后非流畅性失语症患者(试验组，n = 25)和健康被试(对照组，n = 25)，采用改编的言语韵律功能评估工具和声学分析仪器比较两组组块、情感、焦点、交互功能表现的差异。

结果 组块韵律中，两组听分辨不同组块(Z = -4.856, P < 0.001)，听识别“2个组块”(Z = -3.024, P = 0.002)，模仿输出“2个组块”及自主输出“2个组块”和“3个组块”的主观得分、停顿总时长、平均停顿时长、平均音节时长和构音速率(|Z| > 2.911, P < 0.001)存在显著性差异。情感韵律中，两组听分辨不同情感(Z = -3.322, P = 0.001)，听识别“喜欢情感”(Z = -3.481, P = 0.001)，模仿输出“喜欢情感”的主观得分(Z = -6.214, P < 0.001)、平均强度(Z = -3.581, P < 0.001)、强度标准差(Z = -3.181, P = 0.001)，自主输出“喜欢情感”的主观得分(Z = -5.510, P < 0.001)、平均强度(Z = -3.429, P = 0.001)、强度标准差(Z = -4.777, P < 0.001)、基频变化范围(t = 1.852, P = 0.029)存在差异。焦点韵律中，两组听分辨不同重音(Z = -2.658, P = 0.008)，听识别“句尾”重音(Z = -2.023, P = 0.011)，模仿输出“句首”重音的重音强度峰值(t = 8.294, P < 0.001)，模仿输出“句中”“句尾”重音的主观得分(|Z| > 5.102, P < 0.001)、重音强度峰值(t > 8.298, P < 0.001)，自主输出“句首”焦点的主观得分(Z = -4.371, P < 0.001)和重音强度峰值(t = 8.842, P < 0.001)，自主输出“句中”“句尾”焦点的主观得分(|Z| > 4.970, P < 0.001)、重音强度峰值(t > 9.373, P < 0.001)和重音持续时间(|t| > 2.912, P < 0.01)存在显著性差异。交互韵律中，两组听分辨和听识别均无显著差异(P > 0.05)，模仿复述及自主表达疑问语气的主观得分(|Z| > 4.938, P < 0.001)和基频斜率k (|t| > 4.609, P < 0.001)存在显著性差异。

结论 非流畅性失语症患者言语韵律输入和输出功能均下降，在“2个组块”“喜欢情感”“句尾焦点”“疑问语气”的识别和表达上明显异常。

关键词: 脑卒中, 非流畅性失语症, 成年人, 韵律功能, 言语韵律

Abstract:

Objective To explore the characteristics of speech prosody chunking, affect, focus and interaction function in patients with non-fluent aphasia after stroke.

Methods From December, 2023 to March, 2024, patients with non-fluent aphasia after stroke (experimental group, n = 25) and healthy subjects (control group, n = 25) were recruited from Shanghai Fifth Rehabilitation Hospital, and the two groups were compared in terms of chunking, affect, focus and interaction performance using a self-administered speech prosody function assessment tool and acoustic analyzing instrument.

Results In chunking prosody, there were differences in auditory discrimination (Z = -4.856, P < 0.001), auditory recognition of "two chunks" (Z = -3.024, P = 0.002), and subjective scores, total pause duration, average pause duration, average syllabic duration and structural sonic rate (|Z| > 2.911, P < 0.001) of imitating "two chunks" and autonomously outputing "two chunks" and "three chunks" between two groups. In affect prosody, there were differences in listening to distinguish different emotions (Z = -3.322, P = 0.001), listening to identify "like emotion" (Z = -3.481, P = 0.001), and the subjective score (Z = -6.214, P < 0.001), average intensity (Z = -3.581, P < 0.001) and standard deviation of intensity (Z = -3.181, P = 0.001) of imitating "like emotion" between two groups; there were differences in the subjective score (Z= -5.510, P < 0.001), average intensity (Z = -3.429, P = 0.001), standard deviation of intensity (Z = -4.777, P < 0.001) and fundamental frequency variation range (t = 1.852, P = 0.029) of autonomously outputing "like emotion" between two groups. In focus prosody, there were differences in listening to distinguish different focuses (Z = -2.658, P = 0.008), listening to identify the "end of sentence" focus (Z = -2.023, P = 0.011), and the peak stress intensity of imitating the "first sentence" focus (t =8.294, P< 0.001); the subjective score (|Z| > 5.102, P < 0.001) and peak stress intensity (t> 8.298, P < 0.001) of imitating the "mid-sentence" and "end-sentence", and the subjective score (Z = -4.371, P < 0.001) and peak stress intensity (t = 8.842, P < 0.001) of autonomously outputing the focus of the "first sentence" between two groups; there were differences in the subjective score (|Z| > 4.970, P < 0.001), peak stress intensity (t > 9.373, P < 0.001) and stress duration (|t| > 2.912, P < 0.01) of autonomously outputing the focus of the "mid-sentence" and "end-sentence". In the interaction prosody, there were no significant difference in auditory resolution and auditory recognition between two groups (P > 0.05), however, there were significant differences in the subjective score (|Z| > 4.938, P < 0.001) and the fundamental frequency slope k (|t| > 4.609, P < 0.001) of the interrogative tone both in imitative output and autonomous output.

Conclusions Patients with non-fluent aphasia showed significant abnormalities in the recognition and expression of "2 chunks" "like emotion" "sentence-final focus" and "questioning tone."

Key words: stroke, non-fluent aphasia, adults, prosody function, speech prosody

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